NPIMap

Individual provider Active NPI

Ronald E Revard, MD

  • Cardiovascular Disease Physician
  • Harrison, AR
National Provider Identifier
1710970637
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C-6300 Issued in AR
Practice address
702 N. Spring Street
Harrison, AR 72601
Phone
(870) 365-0761
Fax
(870) 365-0763
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C-6300 AR Primary
Cardiovascular Disease Physician 207RC0000X C6300 AR

Addresses

Primary practice location

702 N. Spring Street
Harrison, AR 72601

Mailing address

PO Box 550
Lowell, AR 72745
Phone (479) 463-7775

Other identifiers 1

IdentifierTypeStateIssuer
110646001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000519 AR Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9234264789 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Arkansas College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baxter Regional Enterprises, LLCGroup PAC ID 3476945528, 16 clinicians

Practice addresses (Care Compare)

114 E Crandall Ave
Suite D
Harrison, AR 72601-3628
Phone (870) 741-6065

114 E Crandall Ave B
Baxter Regional Cardiovascular Clinic
Harrison, AR 72601-3628
Phone (870) 425-8288

1420 Hwy 62 65 N
Suite 2
Harrison, AR 72601-1959
Phone (870) 741-6065

15 Green Valley Dr
Suite 100
Mountain Home, AR 72653-8102
Phone (870) 701-4090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C6300ARMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baxter County Regional Hospital Inc CurrentSince Nov 15, 2021 Accepting new patients
Washington Regional Medical System CurrentSince Oct 15, 2016 Accepting new patients
Harrison Cardology Clinic, P a Cardiovascular Disease Current Accepting new patients
Baxter Regional Enterprises, LLC Current Accepting new patients
Baxter Regional Enterprises, LLC CurrentSince Sep 8, 2025 Accepting new patients
Baxter County Regional Hospital, Inc CurrentSince Nov 15, 2021 Accepting new patients
Washington Regional Medical System Current Accepting new patients
Baxter Regional Enterprises, LLC CurrentSince Sep 8, 2025 Accepting new patients
Washington Regional Medical System Past Accepting new patients
Baxter County Regional Hospital Inc Past Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

702 N Spring St
Harrison, AR 72601
Phone (870) 365-0761

1420 Highway 62 65 N
Ste 2
Harrison, AR 72601
Phone (870) 741-6065

114 E Crandall Ave
#C
Harrison, AR 72601
Phone (870) 741-2299

624 Hospital Dr
Mountain Home, AR 72653
Phone (870) 424-1000

15 Green Valley Dr
#100
Mountain Home, AR 72653
Phone (870) 701-0490

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1710970637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "72745",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N. SPRING STREET",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "72601",
            "telephone_number": "870-365-0761",
            "fax_number": "870-365-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVARD",
        "first_name": "RONALD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "C-6300",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "C6300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110646001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

Verify at the official NPI Registry.